Just if you might be really interested in learning the fastest hands-on means we know to get rid of pain on the spot with long lasting functional gains, we're pre-offering the opportunity to sign up for a limited slot pilot class for Rapid Reflexive De-afferentation Techniques (RDTs).
We're gearing to do this by August - September 2009.
Temp dates: August 15-16, August 29-30, September 5-6, 19-20.
Location: Boracay Island
More than the certification, you go home with the chance to correct on the spot structural complaints and to resolve pain that no one else can - faster than NSAIDs, better than opiates.
We invite you to take up this challenge with us.
As soon as you get over arguing with yourself how useful this is for you, your patients, your practice, and your financial well-being, you may signify intent to join us at assist@tuecaremed.com with the subject line "sign me up for RDT training NOW, please!"
Sorry, slots will be limited to maintain heavily hands-on workshop environment.
see you then.
yours in manual med evolution,
Friday, April 10, 2009
treating nonlocal sources of pain
We've been saying for the longest time, treat what you see -- not what you expect to see. That's where all your diagnostic skills come in. That's where years of clinical experience and your exquisite palpation skills come into the fray to save the day.
May we also add, treat the source, not the effects. Treat the cause and any manifestations secondary to that cause will resolve on the spot or in their due time.
Strix
"Indeed, Jody is correct. Yes, Robert treatment of the location of pain is commonplace (in ALL healthcare professions) in what eventually turn out to be areas of projected pain of neuropathic origin.
A commonly neglected example is upper thoracic/scapula region pain projected from lower cervical nerve roots. In many cases, the pain is assumed to have a thoracic tissue origin, and are treated as such.
Another example is tennis or golfers elbow (lateral or medial epicondylalgia) , which often has a neuropathic origin, but is commonly treated as a local tissue 'injury'.
I could go on with examples...
If an answer is FIRST given for the question, 'what is the dominant pain mechanism?', then the treatment is matched to mechanism and the reasoning process to aetiology is facilitated.
David E"
from our yahoo group osteopathyforall
May we also add, treat the source, not the effects. Treat the cause and any manifestations secondary to that cause will resolve on the spot or in their due time.
Strix
"Indeed, Jody is correct. Yes, Robert treatment of the location of pain is commonplace (in ALL healthcare professions) in what eventually turn out to be areas of projected pain of neuropathic origin.
A commonly neglected example is upper thoracic/scapula region pain projected from lower cervical nerve roots. In many cases, the pain is assumed to have a thoracic tissue origin, and are treated as such.
Another example is tennis or golfers elbow (lateral or medial epicondylalgia) , which often has a neuropathic origin, but is commonly treated as a local tissue 'injury'.
I could go on with examples...
If an answer is FIRST given for the question, 'what is the dominant pain mechanism?', then the treatment is matched to mechanism and the reasoning process to aetiology is facilitated.
David E"
from our yahoo group osteopathyforall
Saturday, April 4, 2009
Passive Prone Technique
Passive prone technique notes
On walking.
Setting aside the role of muscles, walking involves several forces. The main forces being:
1. Weight-bearing and leaning.
2. Leg lifting and direction.
3. The changing angles of the Ilia and hip joint.
4. The reciprocal action of the sacroiliac joints.
5. Lumbar vertebral accomodation for this action.
6. the action or contribution of side shift
Let's try an experiment.
Test “A” for rotation.
Ask a colleague to sit sideways on the plinth, with buttocks even, and feet planted firmly flat on the floor.
Weight should be equally balanced at both buttocks.
Stay behind your colleague and place your hands around the pelvis, to block or completely immobilize it.
This isolates lumbar rotation as a motion without contribution from the pelvis.
Now, if muscles are the singular cause of lumbar rotation, then The L3 joint can still rotate.
Ask your colleague to rotate their lumbar region slowly in either direction.
Be very careful not to force the rotation to the point of engaging the pelvic leverage.
Keep the pelvis immobile.
The result of this test is that the lumbar spine blocks after a mere few degrees of rotation.
Now we know that the L3 joint can’t rotate far with the pelvis immobilized
Test “B” for side-bending.
As with previous experiment, we block the pelvis.
This time, we engage the lumbar spine in side bending to either side.
We likewise find that side bending is restricted to mere few degrees.
Test “C” for combined side bending and rotation
blocking the pelvis, ask your colleague side-bend their lumbar spine as best they can toward one side and then attempt to rotate to the opposite side
Now, if Freyette’s laws are correct, This combination movement should account for real-world lumbar rotation in forward bending
We however find that the amount of rotation possible remains minimal and at the lumbar vertebrae.
Test “D” for combined rotation and side-bending
inside and same experiments previous can be repeated, blocking the pelvis and this time starting with lumbar rotation followed by side bending to the same side.
This, according to Fryette’s laws of traditonal spinal mechanics
Is how the lumbar vertebrae in extension.
By extension, we mean that the lumbar spine is in either neutral or forward bending.
Again, lumbar extension is here meant to signify lumbar spine being either neutral or forward bent
trying out the experiment in neutral or forward-bending for combined rotation and Side-bending to the same side, we find that rotation is not improved.
These simple tests shows that isolated combinations of side-bending and rotation and of rotation and side bending for the lumbar spine no not and can not account for the observed real-world amount of lumbar rotation.
Test E.
Adding pelvic side bending.
With your colleague in the same position on previous, prop the a one-inch thick book under the right ischial tuberosity.
This side-bends The sacrum to the left. The lumbar spine becomes side-bent to the left as well.
Now, ask your colleague to rotate to the right, making sure to block all pelvic side-shift to the left.
Your colleague will be able to rotate further to the right for the lumbar area.
We however observe that the circumferential range of rotation still does not equal what we notice in the real world Insofar as lumbar rotation goes
Pelvic criteria.
Test “F.”
Adding side shift left still in the lumbar flexion with the patient is same position as in previous with a block under the right buttocks
Observe that the lumbar spine automatically rotates to the right without any muscular leverage within the sufficient range reflective of real world movements.
Observe the thoracic spine.
Repeat the above test. With your colleague sitting up straight, notice that the thoracic spine refuses to rotate right.
It is important not to force it to rotate.
The thoracic spine is designed to restrict rotation in thoracic extension or backward bending.
This automatic blocking mechanism occurs for forward-bending and neutral
In same position side shift the pelvis to the right (rather than the left, as done previously.) This causes the pelvis automatically rotate right, and almost automatically level out on the horizontal plane.
Observe how the thoracic spine automatically rotates to the right, together with the pelvis and lumbar spine.
On top of this collective rotation the thoracic vertebrae, there is Also an independent movement of the thoracic vertebra into rotation right and side-bending left.
Notice how this collection of movements in combination sufficiently mimics the ranges of segmental motion we regularly observe.
These tests basically tell us that the pelvis provides the angle plus side-shift that enables lumbar and thoracic vertebrae movements we take for granted.
A working model for pelvic articulation must satisfy these working criteria:
1. It has to account for the walking action of the legs
2. It has to account for how the vertebral spine moves to complement the biomechanics of walking.
3. it has to act as a precursor for the lumbar spine to side-bend and rotate in non-neutral (both forward and backward bending)
4. it has to act as precursor for thoracic spine rotation lumbar neutral and forward bending. It has to block thoracic backward bending.
5. The pelvis should not dislocate when completing the first four items.
and now that we've totally ruined your day by destroying virtually everything you thought right about spinal mechanics (they just don't work predictably or even as predicted in the "real world"), would you find yourself joining us to learn an entirely new, extremely effective way of manipulating the entire spine in one session? drop us a line at assist@truecaremed.com to signify your interest.
On walking.
Setting aside the role of muscles, walking involves several forces. The main forces being:
1. Weight-bearing and leaning.
2. Leg lifting and direction.
3. The changing angles of the Ilia and hip joint.
4. The reciprocal action of the sacroiliac joints.
5. Lumbar vertebral accomodation for this action.
6. the action or contribution of side shift
Let's try an experiment.
Test “A” for rotation.
Ask a colleague to sit sideways on the plinth, with buttocks even, and feet planted firmly flat on the floor.
Weight should be equally balanced at both buttocks.
Stay behind your colleague and place your hands around the pelvis, to block or completely immobilize it.
This isolates lumbar rotation as a motion without contribution from the pelvis.
Now, if muscles are the singular cause of lumbar rotation, then The L3 joint can still rotate.
Ask your colleague to rotate their lumbar region slowly in either direction.
Be very careful not to force the rotation to the point of engaging the pelvic leverage.
Keep the pelvis immobile.
The result of this test is that the lumbar spine blocks after a mere few degrees of rotation.
Now we know that the L3 joint can’t rotate far with the pelvis immobilized
Test “B” for side-bending.
As with previous experiment, we block the pelvis.
This time, we engage the lumbar spine in side bending to either side.
We likewise find that side bending is restricted to mere few degrees.
Test “C” for combined side bending and rotation
blocking the pelvis, ask your colleague side-bend their lumbar spine as best they can toward one side and then attempt to rotate to the opposite side
Now, if Freyette’s laws are correct, This combination movement should account for real-world lumbar rotation in forward bending
We however find that the amount of rotation possible remains minimal and at the lumbar vertebrae.
Test “D” for combined rotation and side-bending
inside and same experiments previous can be repeated, blocking the pelvis and this time starting with lumbar rotation followed by side bending to the same side.
This, according to Fryette’s laws of traditonal spinal mechanics
Is how the lumbar vertebrae in extension.
By extension, we mean that the lumbar spine is in either neutral or forward bending.
Again, lumbar extension is here meant to signify lumbar spine being either neutral or forward bent
trying out the experiment in neutral or forward-bending for combined rotation and Side-bending to the same side, we find that rotation is not improved.
These simple tests shows that isolated combinations of side-bending and rotation and of rotation and side bending for the lumbar spine no not and can not account for the observed real-world amount of lumbar rotation.
Test E.
Adding pelvic side bending.
With your colleague in the same position on previous, prop the a one-inch thick book under the right ischial tuberosity.
This side-bends The sacrum to the left. The lumbar spine becomes side-bent to the left as well.
Now, ask your colleague to rotate to the right, making sure to block all pelvic side-shift to the left.
Your colleague will be able to rotate further to the right for the lumbar area.
We however observe that the circumferential range of rotation still does not equal what we notice in the real world Insofar as lumbar rotation goes
Pelvic criteria.
Test “F.”
Adding side shift left still in the lumbar flexion with the patient is same position as in previous with a block under the right buttocks
Observe that the lumbar spine automatically rotates to the right without any muscular leverage within the sufficient range reflective of real world movements.
Observe the thoracic spine.
Repeat the above test. With your colleague sitting up straight, notice that the thoracic spine refuses to rotate right.
It is important not to force it to rotate.
The thoracic spine is designed to restrict rotation in thoracic extension or backward bending.
This automatic blocking mechanism occurs for forward-bending and neutral
In same position side shift the pelvis to the right (rather than the left, as done previously.) This causes the pelvis automatically rotate right, and almost automatically level out on the horizontal plane.
Observe how the thoracic spine automatically rotates to the right, together with the pelvis and lumbar spine.
On top of this collective rotation the thoracic vertebrae, there is Also an independent movement of the thoracic vertebra into rotation right and side-bending left.
Notice how this collection of movements in combination sufficiently mimics the ranges of segmental motion we regularly observe.
These tests basically tell us that the pelvis provides the angle plus side-shift that enables lumbar and thoracic vertebrae movements we take for granted.
A working model for pelvic articulation must satisfy these working criteria:
1. It has to account for the walking action of the legs
2. It has to account for how the vertebral spine moves to complement the biomechanics of walking.
3. it has to act as a precursor for the lumbar spine to side-bend and rotate in non-neutral (both forward and backward bending)
4. it has to act as precursor for thoracic spine rotation lumbar neutral and forward bending. It has to block thoracic backward bending.
5. The pelvis should not dislocate when completing the first four items.
and now that we've totally ruined your day by destroying virtually everything you thought right about spinal mechanics (they just don't work predictably or even as predicted in the "real world"), would you find yourself joining us to learn an entirely new, extremely effective way of manipulating the entire spine in one session? drop us a line at assist@truecaremed.com to signify your interest.
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